Wound Care: What to Expect and When to Seek Help

Most small cuts heal well with prompt cleaning, pressure to stop bleeding and a clean covering. See a clinician promptly for a wound that is deep, gaping, on the face, caused by a bite or a dirty or rusty object, or not healing. Also go if you notice signs of infection, such as spreading redness, warmth, swelling, pus or fever, or if you aren’t sure your tetanus vaccine is up to date. Call 911 for bleeding that won’t stop or a serious injury.

First steps for a minor cut or scrape

MedlinePlus describes basic first aid for minor wounds:

1. Wash your hands.
2. Apply firm, direct pressure with a clean cloth to stop bleeding.
3. Gently clean the wound with mild soap and water.
4. Cover it with a clean, non-stick bandage.

For a small puncture, rinse it under running water for about 5 minutes, then wash with soap. Don’t probe the wound. If something is stuck in it, or part of an object might be missing, get it checked. Don’t pull out an object that is deeply embedded.

Wounds that need a clinician

Contact a provider promptly if a wound:

• Is large or deep, more than about a quarter inch (0.64 cm), or reaches bone
• Is on the face
• Gapes open and may need stitches
• Was caused by a human or animal bite
• Came from a fishhook, a rusty object or stepping on a nail
• Has something embedded in it

Some wounds carry a higher risk of infection. These include bites, punctures, crush injuries, dirty wounds, foot wounds and wounds that weren’t cleaned soon after the injury. People with diabetes or poor circulation should have slow-healing wounds checked early.

Signs of infection

Watch the wound over the next few days. Contact a provider if you notice:

• Increasing redness, warmth or swelling
• Pain that is getting worse or throbbing
• A red streak spreading from the wound
• Pus, or drainage that is thick, discolored or smells bad
• A fever (MedlinePlus’s dressing guidance, for example, says to call for a temperature of 100.5°F (38°C) or higher lasting more than 4 hours)
• A wound that is getting larger or deeper, or looks dark or dried out

Tetanus: when to ask

Tetanus is a serious infection that can enter through wounds. CDC lists higher-risk wounds as puncture or deep wounds, wounds contaminated with dirt, feces or saliva (such as animal bites), and wounds with dead tissue. Adults need a tetanus booster every 10 years to stay protected. MedlinePlus advises seeing a provider for a wound if you haven’t had a tetanus shot in the last 10 years.

If you have a significant wound and aren’t sure when your last tetanus shot was, ask a clinician. Depending on the wound and your vaccination history, they may recommend a vaccine or other treatment. SimrikMed’s vaccinations page includes Tdap.

What happens at a wound care visit

SimrikMed’s wound care service covers minor cuts and wounds, burns, post-surgical wounds and slow-healing wounds such as leg and diabetic ulcers. A visit typically includes:

• Assessment of the wound and your health history, including conditions that affect healing
• Cleaning of the wound
• Dressing: applying or replacing a sterile dressing
• Treatment when appropriate, which may include a prescription topical or oral medicine
• A follow-up plan to monitor healing

Bring a list of your medicines and allergies, and your vaccination record if you have it.

Caring for a wound at home

If you are asked to change dressings at home, follow your provider’s instructions on how often and with what. General principles from MedlinePlus include washing your hands before and after, loosening a stuck dressing with warm water, cleaning gently, patting dry rather than rubbing, and noting the color, amount and smell of any drainage. Contact your provider if drainage isn’t decreasing after a few days, or if the wound looks worse.

Next step

For assessment, cleaning and dressing changes, see SimrikMed’s wound care service. If you have diabetes and a slow-healing wound, regular chronic condition follow-up also matters.